Coronary calcium scoring predicts when chest pain patients can skip invasive testing
![Using computed tomography (CT) to perform coronary artery calcium (CAC) scoring can help identify symptomatic chest pain patients who do not require further testing, according to a new analysis published in Radiology.[1]](/sites/default/files/styles/top_stories/public/2024-03/screen_shot_2024-03-06_at_2.42.41_pm.png.webp?itok=jn2JGD8x)
Using computed tomography (CT) to perform coronary artery calcium (CAC) scoring can help identify symptomatic chest pain patients who do not require further testing, according to a new analysis published in Radiology.[1]
Cardiologists and radiologists alike have been turning to CAC scoring more and more in recent years to evaluate chest pain patients. Compared to invasive coronary angiography (ICA), CAC scoring is less invasive and exposes the patient to much less radiation.
For this latest study, researchers examined data from the DISCHARGE trial, which aimed to compare the safety and effectiveness of CT and ICA among patients presenting with stable chest pain. The group focused on nearly 1,800 symptomatic patients with a mean age of 60 years old who underwent coronary CT scans after being originally referred for ICA. All patients were treated from October 2015 to April 2019 in one of 16 different countries.
Participants were split into three categories: low-risk patients (CAC scores of 0), intermediate-risk patients (CAC scores of 1 to 399) and high-risk patients (CAC scores of 400 or higher). Each participant was then followed for an average of 3.5 years.
Overall, the team found that only 0.5% of low-risk patients went on to experience a major adverse cardiovascular event (MACE) during the study’s follow-up period. The coronary artery disease rate among that group, meanwhile, was just 4.1%.
The MACE rates among intermediate- an high-risk patients, meanwhile, were 1.9% and 6.1%, respectively.
“This finding may indicate that a zero coronary artery calcium score can play a larger role in patient management strategies,” senior author Marc Dewey, MD, professor and vice chair of radiology at Charité – Universitätsmedizin Berlin in Germany, said in a prepared statement. “The findings suggest that patients with stable chest pain and a CAC score of zero may not require ICA using cardiac catheterization because the risk of cardiovascular events is so low.”
Click here to read the full study in Radiology, a journal published by the Radiological Society of North America.
Exploring the many benefits of CAC scoring
Nauman Mushtaq, MD, an interventional cardiologist with Northwestern Medicine, recently spoke to Cardiovascular Business about the many reasons his team has embraced CAC scoring in recent years. The low-cost screening exams play a key role in patient management, he said, often helping care teams determine when a patient may require statin therapy or daily aspirin. Also, performing these scans at off-peak times can help imaging departments bring in additional revenue.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.